Heart disease continues to be the leading cause of death in the United States, with coronary artery disease (CAD) accounting for much of the mortality rate. As such, many interventional techniques have been developed to treat CAD, and surgeries to treat the disease are common. One commonly performed surgery, for example, is coronary artery bypass grafting (CABG), in which a graft, often from the internal mammary artery, is used to bypass an occluded coronary artery to supply blood to the heart.
Although CABG procedures are often quite successful, improvements in such procedures are continually being sought, to reduce patient morbidity and mortality and to improve outcomes. For example, a traditional technique for CABG surgery involves creating a large incision through a patient's sternum, as well as stopping the heart and placing the patient on a cardiopulmonary bypass machine. Many other types of heart surgery similarly require large incisions and cardiopulmonary bypass. Both of these components have significant potential for patient morbidity and increase the overall risk of cardiac surgical procedures. Thus, cardiac surgery techniques involving smaller incisions and/or techniques which can be performed on a beating heart have been developed.
Generally, certain drawbacks typically occur when heart surgery is attempted through smaller incisions. It is often difficult for a surgeon to establish adequate visualization of a heart, to be able to manipulate and use surgical instruments on the heart, to stabilize the position of the heart, and/or to move the heart to a more advantageous position through a relatively smaller incision. Basically, a smaller incision which does not allow a surgeon to split the patient's sternum and widely expose the left thoracic cavity may not allow the surgeon to manipulate the heart, perform the surgical procedure, and view the surgical field at the same time. If such inadequate access to the surgical site is compounded with the difficulty of operating on a moving, beating heart, results of a CABG procedure or other heart surgery will often suffer.
Therefore, it would be advantageous to have devices, systems and methods for enhancing the performance of heart surgery. For example, it would be advantageous to enable a surgeon to operate on a heart through a smaller incision than is conventionally used, while stabilizing and/or positioning the heart with one or more devices inserted through separate, minimally invasive incisions. Such methods, devices and systems would ideally be adaptable for either beating heart procedures or procedures on a stopped heart using cardiopulmonary bypass. At least some of these objectives will be met by the present invention.